Tag: Therapy

Good Grief

Lee Kotsalis ThulinLeave a comment

Therapy is in part a dance of self-disclosure, an opportunity to reveal ourselves to another and – as one of my clients put it – “talk about things I don’t want to talk about.” In my practice at least, the self-disclosure is a two-way street; in developing a therapeutic relationship my clients get to know me as a real person with a real life, and learn at least some of the context of that life.

It’s a two-way street, but not an equally heavily trafficked one. When it comes to therapist self-disclosure, there are two caveats I try to always keep in mind:  1) the person who does most of the talking in the session is the one who’s getting the therapy, and 2) therapist self-disclosure should be undertaken in the service of the client, not the therapist.

I’m therefore pretty mindful of what, when, and how much I share with clients, and usually keep my disclosures to experiences I’ve had with other clients that I think might be instructive, or snippets from my own life that could inform what my client is currently facing.

Through the course of my career, there have been two occasions when the self-disclosure has been less controlled and less controllable: seventeen years ago, when my ever-growing belly announced that something was going on with me, and the past couple of months as I’ve been going through the process of grieving my dad’s passing.

site_description_oros_kallidromo_0_0
The view from Kallidromos Mountain in Greece, near my father’s birthplace.

Birth and death. Seismic life events that break apart and then reconfigure every aspect of our lives. Both times I’ve felt the vulnerability of having a part of my out-of-the-office life follow me into the office, and the concern that its presence might hijack the session and compromise both my own and my client’s ability to put the focus squarely on them.

What I’ve learned (well initially learned, promptly forgot, had to re-learn) is that it is actually much easier and less distracting to acknowledge what’s with us and invite it out into the room than it is to try and pretend it isn’t there. Grief, fear, nausea, all emotions and sensations that seem to breed apace the more we try and ignore or deny them.

What I’ve also (re)learned is that therapy is at its heart a relational connection, and that a large part of the value of that comes from its being a two-way street. I’ve certainly benefited from that — I’ve felt cared for and supported, and watched clients who would describe themselves as undesiring or incapable of connection show tenderness and warm compassion.

I like to think my clients have also benefited, either from recognizing their capacity for responding to and empathizing with another, or from seeing that grief and loss is universal. We all experience it, we all benefit from having others (and ourselves) bear witness to it, we can all find a way to move through it.

What Are You Laughing At?

Lee Kotsalis ThulinLeave a comment

First the Seahawks stumbled and now Jon Stewart’s retiring — it’s been a rough couple of weeks in our household!

Jon Stewart’s announcement that he plans to step away from The Daily Show at the end of the year brought to mind a time in my life when his particular brand of humour greatly helped my own mental (and marital) health.

A number of years ago my husband and I had undertaken a renovation of the home we lived in at the time, a 110 year-old former crack house with good ‘bones’. We started with the top floor and for the duration of the renovation our bed was relocated to the basement. Our new room was a dark and kind of dreary place we affectionately called the Cave, but it did have one redeeming feature our old bedroom had lacked: a TV.

4ff9dc22e2c63
Cartoon by Victor Yalom; permission to reprint by Psychotherapy.net

Now some people may tell you that planning and living through extensive renovations with your spouse will bring the two of you closer together. Step away from those people, they are cruelly lying to you. Like a bucking bronco, the renovation flung off any time and budget lassos we threw to try to contain it, and trampled over our initial enthusiasm and any lingering goodwill in the process. By the time the planned 6-week renovation entered its 3rd month with no end in sight, our patience – for noise, for drywall dust, for cost overruns, for sub-contractors and often for each other – was stretched to the limit.

We got into the habit of crawling into our cave bed at the end of the day and turning on the Daily Show. Jon Stewart’s ability to reliably find the humour (or at least the sardonic wit) in a situation helped us end the day in a calmer and more light-hearted frame of mind, and gave us a point of connection with each other (which would last. Right until the beginning of the next day!)

Donald Winnicott, a psychotherapist whose work was groundbreaking in the area of attachment, was asked by one of his students how he knew when a client he was seeing was someone he would not be able to help. He responded, “When I’ve sat with him for a time and there has been not a single moment of humour or levity.”

Having the ability to find humour, to see and laugh at our own human ridiculousness or the ridiculousness in a situation, is one of the most healing and therapeutic things we can experience. Although a typical therapy session might contain moments of heartfelt anguish and connection to grief or other emotional pain, when it also holds some laughter (as it almost always does), I know we’re on the right track.

Letting it go

Lee Kotsalis ThulinLeave a comment

The first time I heard Frozen‘s Elsa belt out the now ubiquitous “Let it Go” song, I thought it had a familiar ring. That’s because when I ask clients how they think therapy could be helpful to them, “I want to learn how to let it go” is a common response.

The ‘it’ can be a distinct trauma we’ve survived, or the soul-crushing never-ending hum of anxiety. It can be loathing or criticism we heap upon ourselves, a hurt someone else has inflicted, or some other painful emotional pressure. Whatever it is, we all want to learn how to let it go.

By the time difficulty with letting it go has announced itself as a problem, we’ve tried many different ways to get it gone. We’ve drunk (or drugged, or fed, or TV-viewed, or worked, or exercised, or sexed, or slept) ourselves into oblivion, we’ve taken Elsa’s approach and tried to ignore and conceal what we’re struggling with, we’ve started new relationships to get over the hurt of old ones. And yet ‘it’ stubbornly remains, outwaiting and outlasting our efforts to make it go away.

The paradox of letting it go is that we first have to let it come. We have to let ourselves identify and experience what we’re feeling, and accept it. Tory Brach, author of “Radical Acceptance: Embracing Your Life With the Heart of a Buddha” defines radical acceptance as having two elements, “an honest acknowledgment of what is going on inside you, and a courageous willingness to be with life in the present moment, just as it is.” Radically accepting something doesn’t mean condoning it, liking it, or resigning yourself to having it always be so, it simply means becoming more willing to experience all that is present for you in this moment without judging it, resisting it, or pulling away from it. It means noticing your desire to judge, resist, and pull away, and radically accepting that as well.

Carl Jung said that “What you resist, persists” while Buddhist Shinzen Young chose to articulate the issue using a mathematical formula: Suffering = Pain + Resistance. We cannot influence our experience of pain – what has happened has already happened – but by learning how to bring more acceptance to the experience we can save ourselves some suffering.

Do You Need Help?

Lee Kotsalis ThulinLeave a comment

Although you might enjoy therapy – who wouldn’t like having someone’s undivided attention and a space to talk about whatever they wanted without the need for filtering or reciprocation – do you need therapy? Deciding the answer to that question is an inside job, but if you were asking me if I thought you needed therapy, I would want to know a couple of things about you: the nature of the issues you have experienced or are experiencing, and the quality of support you currently have available in your life.

Ultimately, that’s one of the things a therapeutic relationship offers, high quality support to stand with you as you process the issues in your past or present, someone who can help you gain a different perspective, a new direction, or just some peace and resolution.

If you’re trying to determine whether therapy might be right for you, writer and psychotherapist Martha Beck has devised a list of questions to ask yourself. While the list is not exhaustive, I think it is a good starting point:

  1. Is there anyone who knows and cares about all or almost all the significant events of your life?
  2. Do you feel as though you’re living life behind an invisible screen, unable to truly connect with anyone or anything?
  3. Is there at least one person you talk to at least once a week who really understands all or almost all your feelings?
  4. Is there anything you feel you can’t or mustn’t tell anyone?
  5. Do you feel comfortable crying in front of the person or people you love most?
  6. Have you recently suffered any kind of serious emotional wound, such as the loss of a job or a loved one?
  7. Have you benefited from therapy in the past and recently felt wistful about it, missing that kind of reliable support?
  8. Do you have unexpected negative emotional reactions to others’ behavior toward you, such as feeling shame when you are praised or anxiety when you are loved?
  9. Are you able to freely express love to your family and friends?
  10. Does your fear of others’ disapproval dominate your choices?
  11. Are you lonely even if—or especially when—you’re with a group of people?
  12. Do you have to be under the influence of alcohol or drugs in order to be open about your thoughts and emotions?

Finer than Fine

Lee Kotsalis ThulinLeave a comment

A few years ago, when I was working in a Drug and Alcohol Counselling Agency, a client gave me a curious look when she asked how I was doing and I responded “Fine.” She told me in her recovery group she’d learned that fine stood for F***ed Inside, Nice Exterior. Since that day I’ve tried to take that word out of my feelings vocabulary, and hear it a little differently when someone tells me they’re doing “Fine.”

Alexithymia, which literally translates to “without words for feelings,” is a psychological term that’s garnered a fair bit of interest. While there are people – mostly male people according to the research – who may be diagnosable alexithymics, most of us are fewlexithymics. Don’t bother googling, I just made it up; it means using the same narrow range of words to describe our feeling states. So when someone asks us how we’re feeling, we don’t say “effervescent” or “melancholy,” we say “fine” (or “crappy,” as the case may be).

And what’s wrong with that? Well some may argue that putting words to a feeling is an integral part of fully experiencing that feeling (hence the interest in studying alexithymia). And even if there’s nothing lost in not being able to colourfully describe our feeling states, surely there’s something to be gained in finding the word or phrase that aptly captures both the quality and the intensity of what it is we’re experiencing. After all, expressing our feelings is an exercise in connection, first connecting with ourselves (so that we even know what the answer to ‘how am I feeling?’ is) and secondly connecting to another by giving them a glimpse of our internal landscape in that moment. “Fine” gives a broad and unfocused view while “anguished” or “thankful and inspired” or “uncertain and confused” offer a richer and more precise picture.

What I learned from Reality TV (this week)

Lee Kotsalis Thulin1 Comment

I’m a little obsessed with watching the Discovery’s Channel’s Naked and Afraid. Truth be told, I find the purported ‘reality’ in a lot of reality TV pretty fascinating (from a purely psychological perspective of course, I’m not wasting precious hours of my life, I’m doing research!)

For the uninitiated, the premise of Naked and Afraid is to take a man and a woman who are self-described “survivalists” in their normal lives and drop them (naked) in some remote and awe-inspiringly dangerous part of the world, where they do their best to survive the elements and each other for 21 days.

For me at least, the show supplies unending grist for the psychological mill, but here are three of the things that have stood out most:

  1. Shoes are truly the unsung heroes of attire, and much more of a necessity (versus a nice-to-have) than I ever appreciated.
  2. The line we draw between food/not-food is arbitrary and highly context-specific. In my day-to-day life, a severed and partially decomposed bird’s head found of the beach would be solidly in the not-food camp. This show makes the case that 18 days without a solid meal would have one reconsidering that.
  3. It takes a lot of work to make and maintain a fire.

For the Naked and Afraid contestants, fire is fundamental to survival, and they accordingly approach it with a high degree of reverence and care. Today fire (and everything that comes with it) is something most of us take for granted, but the many references to fire that show up in our language speak to its primacy in our ancestral legacy. We ‘light a fire under’ things (or people) to get them going, we question whether or not there’s a ‘spark’ when we meet a potential partner, we say ‘the flame’s gone out’ when passion has taken its leave, we hope for an idea to ‘catch fire’ or watch it go ‘up in smoke.’

Many of the clients I work with come to therapy in part because they’re trying to light or re-ignite a fire. Some have found that depression has dampened all their tinder so that even generating a spark seems unlikely, some are trying to keep the winds of self-doubt from extinguishing intention before it has a chance to catch, and others are poking at the dying embers of a love relationship, wondering if they can be coaxed back to life.

What I’ve learned from the Naked and Afraid contestants is that lighting a fire takes focus and patience, and that timing is everything; the same gust of wind that would encourage a going fire snuffs out the kindling’s flame. I’ve also learned that lighting the fire is only half the battle. Once you have your fire lit (or your project started, or your lover back), you need to keep tending and adding fuel to the fire, all the while keeping an eye out for any rainstorms brewing in the distance.

So this is blogging…

Lee Kotsalis ThulinLeave a comment

 

 

On a recent trip to Las Vegas, my husband and I decided to take in a comedy show. As luck would have it, one of the comedians used his experience of therapy and the relationship with his therapist as the central feature of his routine. I won’t spoil it for you, but the gist was: therapists be crazy! That may be an easy (and predictable) place to lead a punchline, but the larger truth is that therapists (naturally) are people too. We have good days and bad days, self-awareness and blind spots, gifts and quirks and challenges like everybody else.

One of the main challenges I face right along with my clients concerns change. The new, the strange, the unfamiliar; long past the point when doing what we’ve always done stops working, we all find ways to resist – or at least delay – the call to do something different. Of course life’s proficiency at throwing curve balls ensures that “change is the only constant” — but beyond having to reactively cope with the curve balls, I think there’s also value in pushing ourselves out of our comfort zones, choosing to take on the new, the strange, the unfamiliar.

Which brings us to this blog. Many (many!) things have changed in the nearly 20 years since I started working as a therapist, not least of which is the way technology has expanded our avenues for self-expression and the imparting of information. My intention for this blog (beyond challenging myself to learn something new), is that it will do a little bit of both: offer a place for me (and you) to express thoughts, impressions, musings and experiences, and also a place for me (and you) to impart information about topics relevant to therapy, or topics relevant to life.

As with any venture into uncharted waters, there’s safety in numbers! I hope you’ll join me.